Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2/00—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor
  • A61L2/0005—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor for pharmaceuticals, biologicals or living parts
  • A61L2/0082—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor for pharmaceuticals, biologicals or living parts using chemical substances
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2/00—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor
  • A61L2/0005—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor for pharmaceuticals, biologicals or living parts
  • A61L2/0011—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor for pharmaceuticals, biologicals or living parts using physical methods
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2/00—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor
  • A61L2/0005—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor for pharmaceuticals, biologicals or living parts
  • A61L2/0011—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor for pharmaceuticals, biologicals or living parts using physical methods
  • A61L2/0029—Radiation
  • A61L2/0047—Ultraviolet radiation
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2/00—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor
  • A61L2/0005—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor for pharmaceuticals, biologicals or living parts
  • A61L2/0011—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor for pharmaceuticals, biologicals or living parts using physical methods
  • A61L2/0029—Radiation
  • A61L2/0052—Visible light
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2/00—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor
  • A61L2/02—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor using physical phenomena
  • A61L2/08—Radiation
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2/00—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor
  • A61L2/02—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor using physical phenomena
  • A61L2/08—Radiation
  • A61L2/10—Ultra-violet radiation
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2/00—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor
  • A61L2/16—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor using chemical substances
  • A61L2/23—Solid substances, e.g. granules, powders, blocks, tablets
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
  • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
  • A61M1/3616—Batch-type treatment
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
  • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
  • A61M1/3621—Extra-corporeal blood circuits
  • A61M1/3622—Extra-corporeal blood circuits with a cassette forming partially or totally the blood circuit
  • A61M1/36222—Details related to the interface between cassette and machine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
  • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
  • A61M1/3621—Extra-corporeal blood circuits
  • A61M1/3622—Extra-corporeal blood circuits with a cassette forming partially or totally the blood circuit
  • A61M1/36224—Extra-corporeal blood circuits with a cassette forming partially or totally the blood circuit with sensing means or components thereof
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
  • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
  • A61M1/3621—Extra-corporeal blood circuits
  • A61M1/3622—Extra-corporeal blood circuits with a cassette forming partially or totally the blood circuit
  • A61M1/36226—Constructional details of cassettes, e.g. specific details on material or shape
  • A61M1/362263—Details of incorporated filters
  • A61M1/362264—Details of incorporated filters the filter being a blood filter
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
  • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
  • A61M1/3621—Extra-corporeal blood circuits
  • A61M1/3622—Extra-corporeal blood circuits with a cassette forming partially or totally the blood circuit
  • A61M1/36226—Constructional details of cassettes, e.g. specific details on material or shape
  • A61M1/362266—Means for adding solutions or substances to the blood
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
  • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
  • A61M1/3681—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits by irradiation
  • A61M1/3683—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits by irradiation using photoactive agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
• • C—CHEMISTRY; METALLURGY
  • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
  • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
  • C12N7/00—Viruses; Bacteriophages; Compositions thereof; Preparation or purification thereof
  • C12N7/04—Inactivation or attenuation; Producing viral sub-units
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L2202/00—Aspects relating to methods or apparatus for disinfecting or sterilising materials or objects
  • A61L2202/20—Targets to be treated
  • A61L2202/22—Blood or products thereof

Definitions

• BACKGROUND Contamination of blood supplies with infectious microorganisms such as HIV, hepatitis and other viruses and bacteria presents a serious health hazard for those who must receive transfusions of whole blood or administration of various blood components such as platelets, red cells, blood plasma, Factor VIII, plasminogen, fibronectin, anti-thrombin III, cryoprecipitate, human plasma protein fraction, albumin, immune serum globulin, prothrombin complex plasma growth hormones, and other components isolated from blood.
• Blood screening procedures may miss contaminants, and sterilization procedures which do not damage cellular blood components but effectively inactivate all infectious viruses and other microorganisms have not heretofore been available.
• Solvent detergent methods of blood component decontamination work by dissolving phospholipid membranes surrounding viruses such as HIV, and do not damage protein components of blood; however, if blood cells are present, such methods cannot be used because of damage to cell membranes.
• photosensitizers compounds which absorb light of a defined wavelength and transfer the absorbed energy to an energy acceptor, has been proposed for blood component sterilization.
• EP Patent application 196,515 published October 8, 1986, suggests the use of non-endogenous photosensitizers such as porphyrins, psoralens, acridine, toluidines, flavine (acriflavine hydrochloride), phenothiazine derivatives, and dyes such as neutral red, and methylene blue, as blood additives.
• Protoporphyrin which occurs naturally within the body, can be metabolized to form a photosensitizer; however, its usefulness is limited in that it degrades desired biological activities of proteins.
• Chlorpromazine is also exemplified as one such photosensitizer; however its usefulness is limited by the fact that it should be removed from any fluid administered to a patient after the decontamination procedure because it has a sedative effect.
• Patent 4,727,027 issued February 23, 1988 to Wiesehahn, G.P., et al. discloses the use of furocoumarins including psoralen and derivatives for decontamination of blood and blood products, but teaches that steps must be taken to reduce the availability of dissolved oxygen and other reactive species in order to inhibit denaturation of biologically active proteins.
• Photoinactivation of viral and bacterial blood contaminants using halogenated coumarins is described in U.S. Patent 5,516,629 issued May 14, 1996 to Park, et al.
• Patent 5,232,844 issued August 3, 1993 to Horowitz, et al. also disclose the need for the use of "quenchers” in combination with photosensitizers which attack lipid membranes, and U.S. Patent 5,360,734 issued November 1, 1994 to Chapman et al. also addresses this problem of prevention of damage to other blood components.
• Riboflavin (7,8-dimefhyl-lO-ribityl isoalloxazine) has been reported to attack nucleic acids. Photoalteration of nucleic acid in the presence of riboflavin is discussed in Tsugita, A, et al. (1965), "Photosensitized inactivation of ribonucleic acids in the presence of riboflavin," Biochimica et Biophysica Acta 103:360-363; and Speck, W.T. et al. (1976), "Further Observations on the Photooxidation of DNA in the Presence of Riboflavin," Biochimica et Biophysica Acta 435:39-44.
• U.S. Patent No. 5,290,221 issued March 1, 1994 to Wolfe, Jr., et al.
• U.S. Patent No. 5,536,238 issued July 16, 1996 to Bischof.
• U.S. Patent No. 5,290,221 discloses the irradiation of fluid in a relatively narrow, arcuate gap.
• U.S. Patent 5,536,238 discloses devices utilizing optical fibers extending into a filtration medium. Both patents recommend as photosensitizers benzopo ⁇ hryin derivatives which have an affinity for cell walls.
• SUMMARY Methods and apparatuses are provided for treating a fluid or other material to inactivate at least some of the microorganisms and white cells which may be present therein or thereon.
• Such fluids may also contain one or more components selected from the group consisting of protein, e.g. biologically active protein such as a therapeutic protein, blood and blood constituents, without destroying the biological activity of such components.
• the methods comprise:
• One mechanism by which these photosensitizers may inactivate microorganisms is by interfering with nucleic acids, so as to prevent replication of the nucleic acid.
• the term "inactivation of a microorganism” means totally or partially preventing the microorganism from replicating, either by killing the microorganism or otherwise interfering with its ability to reproduce.
• Microorganisms include viruses (both extracellular and intracellular), bacteria, bacteriophages, fungi, blood-transmitted parasites, and protozoa.
• Exemplary viruses include acquired immunodeficiency (HIV) virus, hepatitis A, B and C viruses, sinbis virus, cytomegalovirus, vesicular stomatitis virus, he ⁇ es simplex viruses, e.g. types I and II, human T-lymphotropic retroviruses, HTLV-III, lymphadenopathy virus LAV/IDAV, parvovirus, transfusion-transmitted (TT) virus, Epstein-Barr virus, and others known to the art.
• HIV acquired immunodeficiency
• hepatitis A, B and C viruses sinbis virus
• cytomegalovirus vesicular stomatitis virus
• he ⁇ es simplex viruses e.g. types I and II, human T-lymphotropic retroviruses, HTLV-III,
• Bacteriophages include ⁇ X174, ⁇ 6, ⁇ , R17, T 4 , and T 2 .
• Exemplary bacteria include P. aeruginosa, S. aureus, S. epidermis, L. monocytogenes, E. coli, K. pneumonia and S. marcescens.
• Inactivation of white blood cells may be desirable when suppression of immune or autoimmune response is desired, e.g., in processes involving transfusion of red cells, platelets or plasma when donor white blood cells may be present.
• Materials which may be treated by the methods of this invention include any materials which are adequately permeable to photoradiation to provide sufficient light to achieve viral inactivation, or which can be suspended or dissolved in fluids which have such permeability to photoradiation.
• materials are whole blood and aqueous compositions containing biologically active proteins derived from blood or blood constituents. Packed red cells, platelets and plasma (fresh or fresh frozen plasma) are exemplary of such blood constituents.
• therapeutic protein compositions containing proteins derived from blood such as fluids containing biologically active protein useful in the treatment of medical disorders, e.g.
• factor VIII Von Willebrand factor
• factor IX factor X
• factor XI factor XI
• Hageman factor prothrombin
• anti-thrombin III fibronectin
• plasminogen plasma protein fraction
• immune serum globulin modified immune globulin
• albumin plasma growth hormone
• somatomedin plasminogen streptokinase complex
• ceruloplasmin transferrin
• haptoglobin antitrypsin and prekallikrein
• Other fluids which could benefit from the treatment of this invention are peritoneal solutions used for peritoneal dialysis which are sometimes contaminated during connection, leading to peritoneal infections.
• biologically active means capable of effecting a change in a living organism or component thereof.
• biologically active with respect to “biologically active protein” as referred to herein does not refer to proteins which are part of the microorganisms being inactivated.
• non-toxic with respect to the photosensitizers means low or no toxicity to humans and other mammals, and does not mean non-toxic to the microorganisms being inactivated.
• Substantial destruction of biological activity means at least as much destruction as is caused by po ⁇ hyrin and po ⁇ hyrin derivatives, metabolites and precursors which are known to have a damaging effect on biologically active proteins and cells of humans and mammals.
• substantially non-toxic means less toxic than po ⁇ hyrin, po ⁇ hyrin derivatives, metabolites and precursors that are known for blood sterilization.
• blood product includes blood constituents and therapeutic protein compositions containing proteins derived from blood as defined above. Fluids containing biologically active proteins other than those derived from blood may also be treated by the methods of this invention.
• Decontamination methods of this invention using endogenous photosensitizers and endogenously-based photosensitizer derivatives do not substantially destroy the biological activity of fluid components other than microorganisms. As much biological activity of these components as possible is retained, although in certain instances, when the methods are optimized, some loss of biological activity, e.g., denaturization of protein components, must be balanced against effective decontamination of the fluid. So long as fluid components retain sufficient biological activity to be useful for their intended or natural pu ⁇ oses, their biological activities are not considered to be "substantially destroyed.”
• the photosensitizers useful in this invention include any photosensitizers known to the art to be useful for inactivating microorganisms.
• a "photosensitizer” is defined as any compound which absorbs radiation of one or more defined wavelengths and subsequently utilizes the absorbed energy to carry out a chemical process. Examples of such photosensitizers include po ⁇ hyrins, psoralens, dyes such as neutral red, methylene blue, acridine, toluidines, flavine (acriflavine hydrochloride) and phenothiazine derivatives, coumarins, quinolones, quinones, and anthroquinones.
• Photosensitizers of this invention may include compounds which preferentially adsorb to nucleic acids, thus focusing their photodynamic effect upon microorganisms and viruses with little or no effect upon accompanying cells or proteins.
• Other photosensitizers are also useful in this invention, such as those using singlet oxygen- dependent mechanisms.
• Most preferred are endogenous photosensitizers.
• endogenous means naturally found in a human or mammalian body, either as a result of synthesis by the body or because of ingestion as an essential foodstuff (e.g. vitamins) or formation of metabolites and/or byproducts in vivo.
• endogenous photosensitizers are alloxazines such as 7,8-dimethyl-10-ribityl isoalloxazine (riboflavin), 7,8,10-trimethylisoalloxazine (lumiflavin), 7,8- dimethylalloxazine (lumichrome), isoalloxazme-adenine dinucleotide (flavine adenine dinucleotide [FAD]), alloxazine mononucleotide (also known as flavine mononucleotide [FM ] and riboflavine-5-phosphate), vitamin Ks, vitamin L, their metabolites and precursors, and napththoquinones, naphthalenes, naphthols and their derivatives having planar molecular conformations.
• alloxazines such as 7,8-dimethyl-10-ribityl isoalloxazine (riboflavin), 7,8,10-trimethylisoalloxazine (lumiflavin
• alloxazine includes isoalloxazines.
• Endogenously-based derivative photosensitizers include synthetically derived analogs and homologs of endogenous photosensitizers which may have or lack lower (1-5) alkyl or halogen substituents of the photosensitizers from which they are derived, and which preserve the function and substantial non-toxicity thereof.
• endogenous photosensitizers are used, particularly when such photosensitizers are not inherently toxic or do not yield toxic photoproducts after photoradiation, no removal or purification step is required after decontamination, and treated product can be directly returned to a patient's body or administered to a patient in need of its therapeutic effect.
• Preferred endogenous photosensitizers are: CH 2 OH
• the method of this invention requires mixing the photosensitizer with the material to be decontaminated. Mixing may be done by simply adding the photosensitizer or a solution containing the photosensitizer to a fluid to be decontaminated.
• the material to be decontaminated to which photosensitizer has been added is flowed past a photoradiation source, and the flow of the material generally provides sufficient turbulence to distribute the photosensitizer throughout the fluid to be decontaminated.
• the fluid and photosensitizer are placed in a photopermeable container and irradiated in batch mode, preferably while agitating the container to fully distribute the photosensitizer and expose all the fluid to the radiation.
• the amount of photosensitizer to be mixed with the fluid will be an amount sufficient to adequately inactivate microorganisms therein, but less than a toxic (to humans or other mammals) or insoluble amount.
• optimal concentrations for desired photosensitizers may be readily determined by those skilled in the art without undue experimentation.
• the photosensitizer is used in a concentration of at least about 1 ⁇ M up to the solubility of the photosensitizer in the fluid, and preferably about 10 ⁇ M.
• a concentration range between about 1 ⁇ M and about 160 ⁇ M is preferred, preferably about 10 ⁇ M.
• the fluid containing the photosensitizer is exposed to photoradiation of the appropriate wavelength to activate the photosensitizer, using an amount of photoradiation sufficient to activate the photosensitizer as described above, but less than that which would cause non-specific damage to the biological components or substantially interfere with biological activity of other proteins present in the fluid.
• the wavelength used will depend on the photosensitizer selected, as is known to the art or readily determinable without undue experimentation following the teachings hereof.
• the light source is a fluorescent or luminescent source providing light of about 300 nm to about 700 nm, and more preferably about 340 nm to about 650 nm of radiation. Wavelengths in the ultraviolet to visible range are useful in this invention.
• the light source or sources may provide light in the visible range, light in the ultraviolet range, or preferably a mixture of light in the visible and ultraviolet ranges, more preferably about half in the visible and half in the ultraviolet spectrum, although other ratios could be used.
• One benefit of a mixture of light is that the visible spectrum does not damage platelets but reduces the amount of the more harmful ultraviolet radiation required.
• the activated photosensitizer is capable of inactivating the microorganisms present, such as by interfering to prevent their replication. Specificity of action of the photosensitizer is conferred by the close proximity of the photosensitizer to the nucleic acid of the microorganism and this may result from binding of the photosensitizer to the nucleic acid.
• "Nucleic acid” includes ribonucleic acid (RNA) and deoxyribonucleic acid (DNA). Other photosensitizers may act by binding to cell membranes or by other mechanisms.
• the photosensitizer may also be targeted to the microorganism to be inactivated by covalently coupling to an antibody, preferably a specific monoclonal antibody to the microorganism.
• the fluid containing the photosensitizer may be flowed into a photopermeable container for irradiation.
• container refers to a closed or open space, which may be made of rigid or flexible material, e.g., may be a bag or box or trough. It may be closed or open at the top and may have openings at both ends, e.g., may be a tube or tubing, to allow for flow- through of fluid therein.
• a cuvette has been used to exemplify one embodiment of the invention involving a flow-through system. Collection bags, such as those used with the TrimaTM SpectraTM and apheresis systems of Cobe Laboratories, Inc., have been used to exemplify another embodiment involving batch- ise treatment of the fluid.
• photopermeable means the material of the container is adequately transparent to photoradiation of the proper wavelength for activating the photosensitizer.
• the container has a depth (dimension measured in the direction of the radiation from the photoradiation source) sufficient to allow photoradiation to adequately penetrate the container to contact photosensitizer molecules at all distances from the light source and ensure inactivation of microorganisms in the fluid to be decontaminated, and a length (dimension in the direction of fluid flow) sufficient to ensure a sufficient exposure time of the fluid to the photoradiation.
• a preferred amount of radiation is between about U/cm 2 to 120J/cm 2 .
• the fluid to be treated is placed in a photopermeable container which is agitated and exposed to photoradiation for a time sufficient to substantially inactivate the microorganisms.
• the photopermeable container is preferably a blood bag made of transparent or semitransparent plastic, and the agitating means is preferably a shaker table.
• the photosensitizer may be added to the container in powdered or liquid form and the container agitated to mix the photosensitizer with the fluid and to adequately expose all the fluid to the photoradiation to ensure inactivation of microorganisms.
• Photosensitizer may be added to or flowed into the photopermeable container separately from the fluid being treated or may be added to the fluid prior to placing the fluid in the container.
• photosensitizer is added to anticoagulant and the mixture of photosensitizer and anticoagulant are added to the fluid.
• Enhancers may also be added to the fluid to make the process more efficient and selective.
• enhancers include antioxidants or other agents to prevent damage to desired fluid components or to improve the rate of inactivation of microorganisms and are exemplified by adenine, histidine, cysteine, tyrosine, tryptophan, ascorbate, N- acetyl-L-cysteine, propyl gallate, glutathione, mercaptopropionylglycine, dithiothreotol, nicotinamide, BHT, BHA, lysine, serine, methionine, glucose, mannitol, trolox, glycerol, and mixtures thereof.
• This invention also comprises fluids comprising biologically active protein, blood or blood constituents and also containing endogenous photosensitizer, endogenously-based derivative photosensitizer, or photoproduct thereof made by the method of claim 1.
• the fluid may also contain inactivated microorganisms.
• this method is useful for treating other fluids including fluids which are meant for nourishment of humans or animals such as water, fruit, juices, milk, broths, soups and the like.
• the method is also useful for treating peritoneal or parenteral solutions.
• This invention also includes methods for treating surfaces to inactivate microorganisms which may be present thereon comprising applying to such surfaces an inactivati on-effective, non-toxic amount of an endogenous photosensitizer or endogenously-based photosensitizer derivative and exposing the surface to photoradiation sufficient to activate the photosensitizer.
• the surface may be a food surface such as a fruit, vegetable or animal carcass, surface or surfaces of cut or processed foods.
• Particulate materials such as ground meats may be treated by mixing the photosensitizer with the material and continuing to mix while irradiating to expose fresh surfaces to photoradiation.
• the surface may alternatively be a food preparation surface such as a counter top or storage shelf, or may be a surface of a bathing or washing vessel such as a kitchen sink, bathtub or hot tub, or a swimming pool or the like.
• the surface may be the surface of a living animal or plant, or may be a wound surface.
• the photosensitizer may be applied in a suitable carrier such as water or a solution containing other treatment additives, by spraying, dipping, wiping on, or by other means known to the art.
• a suitable carrier such as water or a solution containing other treatment additives
• the amount of photosensitizer and energy of photoradiation required for treatment will be readily determined by one of skill in the art without undue experimentation depending on the level of contamination and the material being treated.
• This invention also provides a method for treating a fluid or other material as set forth above to inactivate microorganisms which may be present therein comprising adding an inactivation-effective, non-toxic amount of vitamin K5 to said fluid or other material.
• the fluid or other material is irradiated to enhance inactivation of microorganisms.
• using vitamin K5 inactivation occurs in ambient light or in the dark as further discussed in the Examples hereof.
• Fluids containing red blood cells are preferred for treatment by vitamin K5 in the absence of a photoradiation step.
• the K5 compound may also coat surfaces such as blood or peritoneal dialysis tubing sets to assure sterile connections and sterile docking.
• the photoradiation source may be connected to the photopermeable container for the fluid by means of a light guide such as a light channel or fiber optic tube which prevents scattering of the light between the source and the container for the fluid, and more importantly, prevents substantial heating of the fluid within the container.
• a light guide such as a light channel or fiber optic tube which prevents scattering of the light between the source and the container for the fluid, and more importantly, prevents substantial heating of the fluid within the container.
• Direct exposure to the light source may raise temperatures as much as 10 to 15 ° C, especially when the amount of fluid exposed to the light is small, which can cause denaturization of blood components.
• Use of the light guide keeps any heating to less than about 2 ° C.
• the method may also include the use of temperature sensors and cooling mechanisms where necessary to keep the temperature below temperatures at which desired proteins in the fluid are damaged.
• the temperature is kept between about 0°C and about 45°C, more preferably between about 4°C and about 37°C, and most preferably about 22°C.
• This invention also provides a system for treating a fluid to inactivate microorganisms which may be present therein comprising: (a) a container comprising said fluid and an endogenous photosensitizer or endogenously-based photosensitizer derivative, said container being equipped with input means, and having a photopermeable surface sufficient to allow exposure of the fluid therein to an amount of photoradiation sufficient to activate the photosensitizer;
• At least one photoradiation source for providing sufficient photoradiation to the fluid in said container of a type and amount selected to activate the photosensitizer whereby microorganisms present are substantially inactivated.
• the photoradiation source may be a source of visible radiation or ultraviolet radiation or both. Preferably both visible and ultraviolet radiation are provided, and more preferably the photoradiation is about half ultraviolet and half visible although other ratios could be used.
• the photoradiation in both the ultraviolet and visible spectra may be supplied concurrently or sequentially, with the visible portion preferably being supplied first.
• the photoradiation source may be a simple lamp or may consist of multiple lamps radiating at differing wavelengths.
• the photoradiation source should be capable of delivering from about 1 to at least about 120 J/cm 2 .
• the use of mixed ultraviolet and visible light is especially preferred when the photosensitizer is one which loses its capacity to absorb visible light after a period of exposure, such as 7,8-dimethyl-lO-ribityl-isoalloxazine.
• any means for adding the photosensitizer to the fluid to be decontaminated and for placing the fluid in the photopermeable container known to the art may be used, such means typically including flow conduits, ports, reservoirs, valves, and the like.
• the system includes means such as pumps or adjustable valves for controlling the flow of the photosensitizer into the fluid to be decontaminated so that its concentration may be controlled at effective levels as described above.
• photosensitizer is mixed with the anticoagulant feed to a blood apheresis system.
• the pH of the solution is preferably kept low enough, as is known to the art, to prevent detachment of the sugar moiety.
• the photosensitizer is added to the fluid to be decontaminated in a pre-mixed aqueous solution, e.g., in water or storage buffer solution.
• the photopermeable container for the flow-through system may be a transparent cuvette made of polycarbonate, glass, quartz, polystyrene, polyvinyl chloride, polyolefin, or other transparent material.
• the cuvette may be enclosed in a radiation chamber having mirrored walls.
• a photoradiation enhancer such as a second photoradiation source or reflective surface may be placed adjacent to the cuvette to increase the amount of photoradiation contacting the fluid within the cuvette.
• the system preferably includes a pump for adjusting the flow rate of the fluid to desired levels to ensure substantial decontamination as described above.
• the cuvette has a length, coordinated with the flow rate therethrough, sufficient to expose fluid therein to sufficient photoradiation to effect substantial decontamination thereof.
• the cuvette is spaced apart from the light source a sufficient distance that heating of the fluid in the cuvette does not occur, and light is transmitted from the light source to the cuvette by means of a light guide.
• the fluid is placed in a photopermeable container such as a blood bag, e.g. used with the apheresis system described in U.S. Patent No. 5,653,887, and agitated while exposing to photoradiation.
• a photopermeable container such as a blood bag
• Suitable bags include collection bags as described herein. Collection bags used in the SpectraTM system or TrimaTM apheresis system of Cobe Laboratories, Inc. are especially suitable. Shaker tables are known to the art, e.g. as described in U.S. Patent 4,880,788.
• the bag is equipped with at least one port for adding fluid thereto.
• the photosensitizer preferably 7,8-dimethyl-lO-ribityl-isoalloxazine
• the bag is then placed on a shaker table and agitated under photoradiation until substantially all the fluid has been exposed to the photoradiation.
• the bag may be prepackaged with the powdered photosensitizer contained therein. The fluid to be decontaminated may then be added through the appropriate port.
• Decontamination systems as described above may be designed as stand-alone units or may be easily inco ⁇ orated into existing apparatuses known to the art for separating or treating blood being withdrawn from or administered to a patient.
• blood-handling apparatuses include the COBE SpectraTM or TRIMA ® apheresis systems, available from Cobe Laboratories, Inc., Lakewood, CO, or the apparatuses described in U.S. Patent 5,653,887 and U.S. Serial No. 08/924,519 filed September 5, 1997 (PCT Publication No. WO 99/11305) of Cobe Laboratories, Inc. as well as the apheresis systems of other manufacturers.
• the decontamination system may be inserted just downstream of the point where blood is withdrawn from a patient or donor, just prior to insertion of blood product into a patient, or at any point before or after separation of blood constituents.
• the photosensitizer is added to blood components along with anticoagulant in a preferred embodiment, and separate irradiation sources and cuvettes are placed downstream from collection points for platelets, for plasma and for red blood cells.
• the use of three separate blood decontamination systems is preferred to placement of a single blood decontamination system upstream of the blood separation vessel of an apheresis system because the lower flow rates in the separate component lines allows greater ease of irradiation.
• decontamination systems of this invention may be used to process previously collected and stored blood products.
• the fluid may be thinned, exposed to higher energies of radiation for longer periods, agitated for longer periods or presented to photoradiation in shallower containers or conduits than necessary for use with other blood components.
• the endogenous photosensitizers and endogenously-based derivative photosensitizers disclosed herein can be used in pre-existing blood component decontamination systems as well as in the decontamination system disclosed herein.
• the endogenous photosensitizers and endogenously-based derivative photosensitizers of this invention can be used in the decontamination systems described in U.S. Patent Nos. 5,290,221 , 5,536,238, 5,290,221 and 5,536,238.
• Platelet additive solutions comprising endogenous photosensitizers and endogenously-based derivative photosensitizers as described above are also provided herein.
• Platelet additive solutions known to the art may be used for this pu ⁇ ose and include those disclosed in U.S. Patent Nos. 5,908,742; 5,482,828; 5,569,579; 5,236,716; 5,089,146; and 5,459,030.
• Such platelet additive solutions may contain physiological saline solution, buffer, preferably sodium phosphate, and other components including magnesium chloride and sodium gluconate.
• the pH of such solutions is preferably between about 7.0 and 7.4. These solutions are useful as carriers for platelet concentrates to allow maintenance of cell quality and metabolism during storage, reduce plasma content and extend storage life.
• the photosensitizer may be present in such solutions at any desired concentration from about 1 ⁇ M to the solubility of the photosensitizer in the solution, and preferably between about 10 ⁇ M and about 100 ⁇ M, more preferably about 10 ⁇ M.
• the platelet additive solution also comprises enhancers as described above.
• a preferred platelet additive solution comprises sodium acetate, sodium chloride, sodium gluconate, 1.5 mM magnesium chloride, 1 mM sodium phosphate 14 ⁇ M 7,8- dimethyl-10-ribityl-isoalloxazine and preferably also 6 mM ascorbate.
• Figure 1 depicts the riboflavin absorbance spectrum.
• Figure 2 depicts a correlation of light absorbance and hematocrit observed and predicted for red blood cells, and predicted for platelets.
• Figure 3 depicts photodecomposition over time of riboflavin in anticoagulant
• ACD Acid Citrate Dextrose
• Figure 4 depicts the transmission profile of various plastic cuvettes as a function of wavelength.
• the solid line represent a 3.2 mm acrylic cuvette.
• the dotted line ( ) represents a 3.2 mm UV acrylic cuvette.
• the dashed line ( ) represents a 3.2 mm polystyrene (PS) cuvette, and the crossed line indicates a 3.2 mm polycarbonate (PC) cuvette.
• PS polystyrene
• PC polycarbonate
• Figure 5 depicts the light flux required in mW per cm 2 as a function of flow rate, i.e. the flux required to deliver one joule/cm 2 to a sample in the cuvette.
• Figure 6 depicts a blood separation apparatus inco ⁇ orating the photoradiation device of this invention.
• Figure 7 depicts the decontamination assembly of this invention.
• Figure 8 depicts inactivation of bacteria in platelet preparations using vitamin K5 as the photosensitizer as a function of energy of irradiation.
• Figure 9 depicts inactivation of bacteria as a function of platelet preparation and energy of irradiation, using 90% platelets and 10% platelet additive solution (90: 10) and 30% platelets with 70% additive solution (30:70).
• Figure 10 shows the effect on inactivation of virus, bacteriophage and bacteria of adding antioxidants to platelet concentrate.
• Figure 11 shows the inactivation curve for He ⁇ es Simplex type II virus as a function of concentration of photosensitizer at an energy of irradiation of 20J/cm 2 using half ultraviolet and half visible light.
• Figure 12 shows inactivation ofS. epidermidis at varying concentrations of photosensitizer and energies of irradiation.
• Figure 13 shows inactivation of ⁇ X174 at varying concentrations of photosensitizer and energies of irradiation.
• Figure 14 shows inactivation of S. aureus and ⁇ X174 at varying energies of irradiation using a 50:50 mixture of ultraviolet and visible light.
• Figure 15 shows inactivation of S. epidermidis and HSV-II at varying energies of irradiation using a 50:50 mixture of ultraviolet and visible light.
• Figure 16 shows inactivation of HSV2 virus in blood bags agitated and irradiated at varying energy levels.
• Figure 17 compares inactivation results for vaccinia virus in various fluids using ultraviolet light alone or 50:50 visible and ultraviolet light.
• Figure 18 compares inactivation results with and without sensitizer of vaccinia virus at varying irradiation times.
• Figure 19 compares inactivation of extracellular HIV-1 at 5 and 50 ⁇ M of photosensitizer and varying irradiation energies.
• Figure 20 compares inactivation of intracellular HIV- 1 at 5 and 50 ⁇ M of photosensitizer and varying irradiation energies.
• Figure 21 compares inactivation of intracellular HIV-1 at 5 and 50 ⁇ M of photosensitizer and varying irradiation energies, using p24 antigen levels.
• Figure 22 shows inactivation of HSV-II at varying irradiation levels using platelet concentrate and platelet concentrate in media containing platelet additive solution with ascorbate.
• Figure 23 shows an embodiment of this invention using a blood bag to contain the fluid being treated and photosensitizer and a shaker table to agitate the fluid while exposing to photoradiation from a light source.
• the decontamination method of this invention using endogenous photosensitizers and endogenously-based derivative photosensitizers is exemplified herein using 7,8-dimethyl-10-ribityl isoalloxazine as the photosensitizer, however, any photosensitizer may be used which is capable of being activated by photoradiation to cause inactivation of microorganisms.
• the photosensitizer must be one which does not destroy desired components of the fluid being decontaminated, and also preferably which does not break down as a result of the photoradiation into products which significantly destroy desired components or have significant toxicity.
• the wavelength at which the photosensitizer is activated is determined as described herein, using literature sources or direct measurement.
• apparatuses may be designed which provide the correct flow rates, photopermeabilities, and light intensities to cause inactivation of microorganisms present in the fluid, as is taught herein.
• the fluid to be decontaminated is mixed with photosensitizer and then irradiated with a sufficient amount of photoradiation to activate the photosensitizer to react with microorganisms in the fluid such that microorganisms in the fluid are inactivated.
• the amount of photoradiation reaching microorganisms in the fluid is controlled by selecting an appropriate photoradiation source, an appropriate distance of the photoradiation source from the fluid to be decontaminated, which may be increased through the use of light guides to carry the photoradiation directly to the container for the fluid, an appropriate photopermeable material for the container for " the fluid, an appropriate depth to allow full penetration of the photoradiation into the container, photoradiation enhancers such as one or more additional photoradiation sources, preferably on the opposite side of the container from the first, or reflectors to reflect light from the radiation source back into the container, appropriate flow rates for the fluid in the container and an appropriate container length to allow sufficient time for inactivation of microorganisms present. Temperature monitors and controllers may also be required to keep the fluid at optimal temperature.
• Figure 6 depicts a decontamination system of this invention as part of an apparatus for separating blood components
• Figure 7 provides details of a preferred decontamination system.
• the fluid to be decontaminated along with photosensitizer in bags which are photopermeable or at least sufficiently photopermeable to allow sufficient radiation to reach their contents to activate the photosensitizer.
• Sufficient photosensitizer is added to each bag to provide inactivation, preferably to provide a photosensitizer concentration of at least about 10 ⁇ M, and the bag is agitated while irradiating, preferably at about 1 to about 120 J/cm 2 for a period of between about 6 and about 36 minutes to ensure exposure of substantially all the fluid to radiation.
• a combination of visible light and ultraviolet light is used concurrently.
• the photosensitizer may be added in powdered form.
• the method preferably uses endogenous photosensitizers, including endogenous photosensitizers which function by interfering with nucleic acid replication.
• 7,8-dimethyl-lO-ribityl isoalloxazine is the preferred photosensitizer for use in this invention.
• the chemistry believed to occur between 7,8-dimethyl-lO- ribityl isoalloxazine and nucleic acids does not proceed via singlet oxygen-dependent processes (i.e. Type II mechanism), but rather by direct sensitizer-substrate interactions (Type I mechanisms).
• Chem., 23:420-429 clearly demonstrate the effects of 7,8-dimethyl-lO-ribityl isoalloxazine are due to non-singlet oxygen oxidation of guanosine residues.
• adenosine bases appear to be sensitive to the effects of 7,8-dimethyl-lO-ribityl isoalloxazine plus UV light. This is important since adenosine residues are relatively insensitive to singlet oxygen- dependent processes.
• 7,8-dimethyl-lO-ribityl isoalloxazine appears not to produce large quantities of singlet oxygen upon exposure to UV light, but rather exerts its effects through direct interactions with substrate (e.g., nucleic acids) through electron transfer reactions with excited state sensitizer species.
• FIG. 6 shows a blood apparatus device and apheresis system inco ⁇ orating the photoradiation devices of this invention.
• Whole blood is withdrawn from a donor/patient 4 and is provided to an apheresis system or blood component separation device 8 where the blood is separated into the various component types and at least one of these blood component types is removed from the device 8.
• These blood components may then be provided for subsequent use by another or may undergo a therapeutic treatment and be returned to the donor/patient 4.
• blood is withdrawn from the donor/patient 4 and directed through an extraco ⁇ oreal tubing circuit 10 and a blood- processing vessel 12, defining a completely closed and sterile system.
• the blood component separation device 8 is connected to a pump (not shown). Blood flows from the donor/patient 4 through the extraco ⁇ oreal tubing circuit 10 and into rotating blood processing vessel 12.
• the blood within the blood processing vessel 12 is separated into various blood component types, and these component types (platelets, plasma, red blood cells) are continually removed from the blood processing vessel 12.
• Blood components which are not being retained for collection or for therapeutic treatment e.g., red blood cells, white blood cells, plasma
• Operation of the blood component separation device is preferably controlled by one or more computer processors included therein.
• Extraco ⁇ oreal tubing circuit 10 comprises a cassette assembly 14 and a number of tubing assemblies 20, 50, 60, 80, 90, 100 interconnected therewith.
• Blood removal/return tubing assembly 20 provides a single needle interface between a donor/patient 4 and cassette assembly 14, and blood inlet/blood component tubing subassembly 60 provides the interface between cassette assembly 14 and blood processing vessel 12.
• An anticoagulant tubing assembly 50, platelet collection tubing assembly 80, plasma collection tubing assembly 90, red blood cell collection tubing assembly 70 and vent bag tubing subassembly 100 are also interconnected with cassette assembly 14.
• the blood removal/return tubing assembly 20 includes a needle subassembly 30 interconnected therewith and anticoagulant tubing 26 connecting to anticoagulant tubing assembly 50 through cassette assembly 14.
• Cassette assembly 14 includes front and back molded plastic plates that are hot- welded together to define a rectangular cassette member having integral fluid passageways.
• the cassette assembly 14 further includes a number of outwardly extending tubing loops interconnecting various integral passageways.
• the integral passageways are also interconnected to the various tubing assemblies.
• cassette assembly 14 interconnects with anticoagulant tubing 26 of the blood removal/return tubing assembly 20 and with anticoagulant tubing assembly 50.
• the anticoagulant tubing assembly 50 includes a spike drip chamber 52 connectable to anticoagulant and photosensitizer source 53 and a sterilizing filter 56.
• the anticoagulant tubing assembly 50 supplies anticoagulant mixed with photosensitizer to the blood removed from donor/patient 4 to reduce or prevent any clotting in the extraco ⁇ oreal tubing circuit 10.
• Many anticoagulants are known to the art, e.g. as disclosed in Chapter 3 of the AABB Technical Manual, 11th edition, 1993, including ACD-A, CPD, CP2D, CPDA-1 and heparin. These as well as cell storage solutions , AS-1, AS-3 and AS-5, are all compatible with the endogenous photosensitizers and endogenously-based derivative photosensitizers described herein.
• Cassette assembly 14 also includes an interconnection with blood removal tubing of the blood removal/return tubing assembly 20. Blood passes through pressure sensors, and an inlet filter in cassette assembly 14 and thence to blood inlet tubing 62. Blood inlet tubing 62 is also interconnected with blood processing vessel 12 to provide whole blood thereto for processing.
• the blood inlet/blood component tubing assembly 60 further includes red blood cell (RBCVplasma outlet tubing, platelet outlet tubing and plasma outlet tubing interconnected with co ⁇ esponding outlet ports on blood processing vessel 12.
• the red blood cell (RBCVplasma outlet tubing channels the separated red blood cell
• Blood product 180 (which may be recently collected blood or blood component or stored blood) is connected to blood product line 186 which leads through pump 184 to decontamination cuvette 164.
• Photosensitizer reservoir 166 is connected to photosensitizer input line 168 equipped with input pump 170, and leads into blood product line 186 upstream from decontamination cuvette 164.
• Decontamination cuvette 164 is a photopermeable cuvette of a depth (d) and a length (1) selected to ensure decontamination.
• Cooling system 190 combined with temperature monitor 192 are connected with decontamination cuvette 164 for controlling the temperature of the fluid.
• Decontamination cuvette 164 is connected via light guide 162 to photoradiation source 160.
• a photoradiation enhancer 163 is placed adjacent to (either touching or spaced apart from) decontamination cuvette 164 to increase the amount of photoradiation reaching the blood product in the cuvette.
• Decontaminated blood product line 188 leads from decontamination cuvette 164 to decontaminated blood product collection 182.
• blood product 180 is conducted into blood product line 186 where it is joined by photosensitizer from photosensitizer reservoir 166 flowing at a rate controlled by photosensitizer input pump 170 in photosensitizer input line 68 which joins blood product line 186.
• the flow rate in blood product line 186 is controlled by pump 184 to a rate selected to ensure decontamination in decontamination cuvette 164.
• Temperature monitor 192 measures the temperature of fluid in cuvette 164 and controls cooling system 190 which keeps the temperature in the cuvette within a range required for optimal operation.
• the blood product in decontamination cuvette 164 is i ⁇ adiated by photoradiation from photoradiation source 160 conducted in light guide 162.
• the photoradiation source may comprise two or more actual lights.
• the a ⁇ ows indicate photoradiation from the end of light guide 162 propagating in the blood product inside transparent decontamination cuvette 164.
• Adjacent to decontamination cuvette 164 is photoradiation enhancer 163 which may be an additional source of photoradiation or a reflective surface.
• the a ⁇ ows from photoradiation enhancer 163 pointing toward decontamination cuvette 164 indicate photoradiation from photoradiation enhancer 163 shining on the blood product material in cuvette 164.
• Decontaminated blood product exits decontamination cuvette 164 via decontaminated blood product line 188 and is collected at decontaminated blood product collection 182.
• a light guide from EFOS Co ⁇ oration, Williamsville, N.Y. composed of optical fibers is used.
• the system is capable of delivering a focused light beam with an intensity of 6,200 mW/cm 2 in the region of 355-380 nm. It is also possible to use interchangeable filters with the system to achieve outputs of 4,700 mW/cm 2 in the spectral region of 400-500 nm. In both cases, the output of light in the region of 320 nm and lower is negligible.
• Light guides of varying dimensions (3, 5 and 8 mm) are available with this system.
• the 8 mm light guide is appropriate, co ⁇ ectly placed, to adequately illuminate the face of the prefe ⁇ ed decontamination cuvette which is a standard cuvette used on Cobe Spectra ® disposables sets from Industrial Plastics, Inc., Forest Grove, OR.
• the flow rate is variable and is determined by the amount of light energy intended to be delivered to the sample.
• the flow rate is controlled by means of a peristaltic pump from the Cole-Parmer Instrument Company, Vernon Hills, IL.
• Flow rates and type of input stream may be controlled via a computer processor as is known to the art.
• Figure 23 depicts an embodiment of this invention in which fluid to be decontaminated is placed in a blood bag 284 equipped with an inlet port 282, through which photosensitizer in powder form 284 is added from flask 286 via pour spout 288.
• Shaker table 280 is activated to agitate the bag 284 to dissolve photosensitizer 290 while photoradiation source 260 is activated to i ⁇ adiate the fluid and photosensitizer in bag 284.
• the bag can be provided prepackaged to contain photosensitizer and the fluid is thereafter added to the bag.
• the methods of this invention do not require the use of enhancers such as "quenchers” or oxygen scavengers, however these may be used to enhance the process by reducing the extent of non-specific cell or protein-damaging chemistry or enhancing the rate of pathogen inactivation.
• enhancers such as "quenchers” or oxygen scavengers
• Further prefe ⁇ ed methods using non-toxic endogenous photosensitizers and endogenously-based derivative photosensitizers do not require removal of photosensitizers from the fluid after photoradiation. Test results show little or no damage to other blood components, e.g. platelets remain biologically active five days post-treatment.
• 7,8-dimethyl-lO-ribityl isoalloxazine was mixed with Isolyte S until a precipitate was formed.
• the mixture was agitated at room temperature for one hour and vortex mixed to ensure complete dissolution of the suspended material. Additional
• 7,8-dimethyl-lO-ribityl isoalloxazine was added until a solid suspension remained despite additional vortex mixing. This suspension was then centrifuged to remove undissolved material. The supernatant from this preparation was removed and analyzed using a spectrophotometer. The absorbance values of the solution were determined at 447 nm and 373 nm. From the extinction coefficients that were determined previously, it was possible to estimate the concentration of the saturated solution
• a solution of 7,8-dimethyl-lO-ribityl isoalloxazine in Sigma ACD-A was prepared at a concentration of 63 ⁇ g/mL. This preparation was taken up into a glass pipette and placed in the path of a UV light source (365 nm ⁇ max with filters to remove light below 320 nm). The suspension was i ⁇ adiated for specific intervals at which aliquots were removed for spectroscopic analysis. The absorbance of the dissolved 7,8-dimethyl-lO-ribityl isoalloxazine was monitored at 373 and 447 nm at each time interval. The results are depicted in Figure 3 and Table 1.
• the abso ⁇ tion profile for the solution at 373 nm indicates that no significant decomposition of the reagent occu ⁇ ed over the entire i ⁇ adiation period.
• the absorbance of light at this wavelength co ⁇ esponds to n- ⁇ * electronic transitions.
• the absence of a decrease in the intensity of this peak over time indicates that the ring structure of the molecule is intact despite prolonged i ⁇ adiation under these conditions.
• the absorbance of the molecule at 447 nm is due to ⁇ - ⁇ * electronic state transitions.
• the decrease in the absorbance of the molecule at this wavelength with increasing i ⁇ adiation times is indicative of subtle alterations in the resonance structure of the molecule.
• the existing Spectra cuvette is composed of polycarbonate.
• the light transmission properties of this cuvette were measured at 373 and 447 nm by placing the cuvette in the light path of a UV spectrophotometer. The values obtained were as follows:
• the volume of solution present in the i ⁇ adiation zone of the cuvette is ca. 0.375 mis.
• the transit time for a cell in this region of the cuvette can be determined from the following equation:
• T Volume of Cuvette (mis) Flow Rate (mls/min)
• Figure 2 shows how absorbance should vary with concentration of platelets.
• Samples of iron (III) oxalate were prepared in the test material (water or blood product at varying red cell hematocrits) at a concentration of 0.15 M. These samples were then loaded into a standard Spectra cuvette and placed in the i ⁇ adiation assembly. Samples were exposed for pre-determined time intervals co ⁇ esponding to the desired energy dose level (1 J/cm 2 ). The samples were then removed and the amount of conversion of Fe 3+ to Fe 2+ was determined by reading the absorbance of the test article in a 1 , 10-phenanthroline solution at 510 nm as described in Gordon, A.J. and Ford, R.A., supra. Higher absorbance values are indicative of greater light penetration into the sample. The absorbance value observed for water after exposure to 1 J/cm 2 UV radiation was used as the 100% Transmittance level. All values for red cell samples were determined relative to this standard.
• the value for the extinction coefficient permits calculation of the penetration distance of UV light into red cell samples as a function of the sample hematocrit. For this estimation, the penetration depth of the sample in which 90% of the incident light would be absorbed was determined using the following equation:
• Figure 2 shows how absorbance and distance from the light source varies for red blood cells, comparing predicted with observed values.
• Example 6 Effects of Virus Inactivation Treatment on Platelet In Vitro Parameters.
• Samples were prepared with three different concentrations of 7,8-dimethyl- 10- ribityl isoalloxazine. Platelets obtained from a standard Spectra LRS collection were used for these studies.
• HSR hypotonic shock response
• Platelet quality was monitored as a function of i ⁇ adiation conditions (sensitizer concentration and flow rates/Energy levels).
• the platelet quality includes parameters such as HSR response, GMP-140 activation, etc.
• the flow rates that are studied can be related to the Energy of exposure as follows:
• F r Flow Rate (mls/min)
• control samples included the following:
• a normal donor platelet apheresis product was obtained from an AABB accredited blood banking facility. The sample was collected using standard Spectra
• the sample was transfe ⁇ ed to a 500 mis PVC transfer pack and centrifuged at 5000 x g for five minutes to pack the platelets. Plasma was then removed from the platelet pellet using a standard plasma press. The plasma was retained for further use. The plasma removed from the cell pellet was then mixed with a stock solution of Isolyte S, pH 7.4; McGaw, Inc. This stock solution of media was prepared by adding a pre-determined amount of 7,8-dimethyl-lO-ribityl isoalloxazine to Isolyte S to provide final concentrations of 1.43, 71.4, and 143 ⁇ M. Following addition of 7,8-dimethyl- 10-ribityl isoalloxazine the stock solution was filtered through a 0.22 ⁇ M sterile filter.
• the platelet pellet was then resuspended in the plasma:media mixture to the original volume of the starting sample.
• the sample was connected to a flow apparatus comprising a container for cells and photosensitizer, a container for media, said containers being connected via valved lines to a single line for mixed cells/sensitizer and media equipped with a pump.
• Mixed cells/sensitizer and media were flowed into a cuvette held in a holder with a mi ⁇ ored wall, i ⁇ adiated by a light source. This i ⁇ adiation chamber was equipped with a temperature probe. After passing through the cuvette, fluid was collected in a product bag.
• the tubing set was initially primed with Isolyte S media. Five minutes prior to the start of the test sample flow, the light source was activated. Temperature was monitored during this interval and kept lower than 32°C in the i ⁇ adiation chamber.
• the flow rate for the sample through the i ⁇ adiation chamber was determined by the chart of Table 4. Flow rates which provide total i ⁇ adiation energy levels of 1, 5 and 9 J/cm 2 were utilized according to the following testing matrix:
• a sample volume of 20 mis per run condition was collected for each sample.
• Results for each set of test variables were compared for the defined conditions of energy of exposure and concentration of 7,8-dimethyl-lO-ribityl isoalloxazine. Direct comparison to the untreated control sample was made and significant differences defined by a probability p>0.05 from a paired, one-tailed, Student's T-Test analysis.
• Values for the light penetration depth using the proposed configuration indicate that delivery in sufficient UV energy to drive virus inactivation processes is achievable even for samples with high hematocrits.
• a platelet concentrate was mixed with the platelet additive solution Isolyte S at a ratio of 20:80 platelet concentrate:Isolyte S. Mixtures of platelet concentrates and platelet additive solutions are refe ⁇ ed to herein as in "media.” Platelet concentrate without additive solution is refe ⁇ ed to herein as in "plasma.” Both were spiked with Listeria monocytogenes. Vitamin K5 was then added to each in the amount of 300 ⁇ g/mL B. Each was then exposed to UV, visible or room light in the cuvette apparatus of Figure 7 with the results shown in Table 6.
• Pathogen Listeria monocytogenes
• Example 10 To platelet concentrate as described in Example 8 and to 70:30 media as described in Example 10 was added 10 ⁇ M of 7,8-dimethyl-lO-ribityl isoalloxazine.
• the platelet concentrate and media were spiked with S. aureus or S. epidermidis, and i ⁇ adiated at 80 J/cm 2 and 30 J/cm 2 and inactivation measured as above. Results are shown in Figure 9.
• Example 12 To plasma concentrate as described in Example 8 contained in a standard blood bag was added 25 ⁇ M 7,8-dimethyl-lO-ribityl isoalloxazine in powder form. The bag was spiked with bacteria as shown in Table 9, agitated and exposed to 120 J/cm 2 radiation. Inactivation results are set forth in Table 9. Table 9
• Example 8 To platelet concentrate as described in Example 8 was added 7,8-dimethyl-lO- ribityl isoalloxazine, alloxazine mononucleotide, or 7-8-dimethyl alloxazine, followed by spiking with S. aureus or S. epidermidis, and i ⁇ adiation at 80 J/cm 2 . Inactivation results are shown in Table 10.
• Example 8 To platelet concentrate of Example 8 was added 10 ⁇ M 7,8-dimethyl- 10-ribityl- isoalloxazine. Aliquots contained no additive, 10 mM ascorbate or 10 mM KI as a "quencher” or antioxidant. The solutions were spiked with HSV-2, ⁇ X174, S. epidermidis or S. aureus and i ⁇ adiated at 80 J/cm 2 . Results are shown in Figure 10.
• Example 8 To platelet concentrates of Example 8 were added varying concentrations of 7,8- dimethyl- 10-ribityl-isoalloxazine. These solutions were spiked with herpes simplex virus type II (HSV-II), a double-stranded DNA envelope virus. I ⁇ adiation was done at 80 J/cm 2 . The experiment was replicated three times. In all three trials complete inactivation was achieved. Results are shown in Figure 11.
• HSV-II herpes simplex virus type II
• Example 16 The protocol of Example 15 was followed using S. epidermidis instead of HSV
• Example 15 The protocol of Example 15 was followed using ⁇ X174, a single stranded DNA bacteriophage, at varying concentrations of 7,8-dimethyl- 10-ribityl-isoalloxazine and energies of i ⁇ adiation. Inactivation results are shown in Figure 13.
• Example 8 To platelet concentrates of Example 8 was added 10 ⁇ M 7,8-dimethyl- 10- ribityl-isoalloxazine. These were spiked with S. aureus or ⁇ X174 and i ⁇ adiated at varying energies of i ⁇ adiation with a 50:50 mixture of visible and ultraviolet light.
• Example 18 The protocol of Example 18 was followed using S. epidermidis and HSV-II as the microorganisms. A 50:50 mixture of ultraviolet and visible light was supplied by DYMAX light source. Inactivation results are shown in Figure 15.
• Example 8 To platelet concentrate of Example 8 was added 10 ⁇ M 7,8-dimethyl- 10-ribityl- isoalloxazine in powdered form. Tests with and without added ascorbate were conducted. 150 ml of the test solutions were placed in a SpectraTM blood bag and shaken and exposed to varying energies of i ⁇ adiation using 50:50 visible:ultraviolet light. After receiving 40 J/cm 2 , the contents of each bag were transfe ⁇ ed to a new bag to avoid e ⁇ ors due to microorganisms which may have remained in the spike port of the bag. Inactivation results are shown in Figure 16. Downward a ⁇ ows indicate inactivation to the level it was possible to detect (2.5 log titre).
• Isolyte S To platelet concentrate of Example 8 and platelet concentrate in Isolyte S at 30:70 platelet concentrate: Isolyte S, was added 20 ⁇ M 7,8-dimethyl- 10-ribityl- isoalloxazine. These were spiked with vaccinia virus, a double stranded DNA envelope virus, and exposed to 60 J/cm 2 visible light or mixed (50:50) visible and ultraviolet light using a DYMAX 2000 UV light source for 30 minutes. The limit of detection was 1.5 logs. Inactivation results are show in Figure 17.
• Example 24 To samples of platelet concentrate as described in Example 8 were added 5 ⁇ M or 50 ⁇ M 7,8-dimethyl- 10-ribityl-isoalloxazine. Samples were spiked with HIV 1. Using the cuvette flow cell shown in Figure 7, samples were i ⁇ adiated with 50:50 visible:UV light at varying energies using an EFOS light system. Inactivation results are show in Figure 19. Example 24.
• HlV-infected ACH-2 cells were added to samples of platelet concentrate described in Example 8. 5 or 50 ⁇ M of 7, 8-dimethyl- 10-ribityl-isoalloxazine were added to the samples. The protocol of Example 23 was followed, and inactivation results are shown in Figure 20. The presence of HIV was assayed by its cytopathic effect on test cells.
• Example 24 The protocol of Example 24 was followed and the presence of HIV assayed by quantifying the level of P24 antigen production. Inactivation results are show in Figure 21.

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