METHOD OF OBTAINING FACTOR VIII

Abstract: Factor VIII is obtained by (a) adding heparin to freshly obtained blood plasma collected into a calcium chelating anti-coagulant or collecting blood plasma by plasmapheresis using heparin and a calcium chelating anti-coagulant; (b) freezing the plasma; (c) resolubilising the plasma; (d) isolat­ ing a cryoprecipitate from the plasma; (e) resolubilising the cryoprecipitate; (f) adding a citrate saline heparin buffer to the resolubilised cryoprecipitate: (g) incubating the buffered, resolubilised cryoprecipitate, e.g. at 0 to 10°C for at least one hour, thereby insolubilising Factor VIII present in the cryo­ precipitate using heparin-precipitable cold-insoluble globu­ lin, the resulting Factor VIII-rich precipitate also including cold-insoluble globulin; (h) separating the factor VIII-rich pre­ cipitate; and (i) isolating the Factor VIII therefrom. By this method, as much as 81 % of the Factor VIII can be recovered in the cryoprecipitate and as much as 62 % of the starting Factor VIII activity with the cold-insoluble globulin.

Description: 1\METHOD OF OBTAINING FACTOR VIII This invention is concerned with a method of obtaining Factor VIII without the use of chemical precipitating agents. The technique relies on the heparin-induced coprecipitation of Factor VIII with a plasma protein called cold-insoluble globulin (CIg). In 1954, Thomas et al in a paper entitled "Cold precipitation by heparin of a protein in rabbit and human plasma" Proc. Soc. Exp. Biol. Ned. 86: 813-819 reported the occurrence of heparin-induced cold or cryoprecipitate plasma from endotoxin-treated rabbits. This fraction has since come to be known as the heparin-precipitable fraction of plasma. Subsequent studies reported in i957 by Smith and Von Korff in a paper entitled "A heparin-precipitable fraction of human plasma. I. Isolation and characterization of the fraction." J. Clin. Invest. 36: 596-604 and Smith in a paper entitled "A heparin-precipitable fraction of human plasma II. Occurrence and significance of the fraction in normal individuals and in various disease states." J. Coin. Invest., 36: 605-616, showed that large amounts of this cold-precipitable fraction were formed from plasmas of patients with certaininflammatory infectious and neo-plastic diseases when heparin was added to the plasma. In normal donors, the amount produced was usually less. At this time it was established that fibrinogen was a najor component of this fraction. A second minor component of the fraction was also observed which was termed "cold-insoluble globulin". This cold-insoluble globulin (CIg) is known to be a normal plasma glycoprotein that is structurally and immunochemically distinct from fibrinogen and all other plasma proteins. CIg normally circulates at plasma levels of 0.33 + O.lg/litre. Cold-insoluble globulin in its various lords has been designated by a variety of terms, of which "fibronectin" has recently become most accepted (The Structure and Biologic Activities of Plasma Fibronectin, Mosesson et al, Blood, Volume 56, No. 2, pages 145-158). In 1974, U.S. Patent No. 3,803,115 was issued to Fekete et al for a method of improving the yield of Factor VIII or A.H.F. obtained from blood plasma or plasma fractions which involved the addition of heparin to a concentrate of A.H.F. obtained from the plasma or plasma fraction by cryoprecipitation. This patent was reissued July 11, 1978 under Re 29698. In the reissue patent, Fekete et al indicate that the addition of heparin is made to an A.H.F. concentrate obtained from blood plasma or a plasma fraction by cryoprecipitation which may then be further fractionated to obtain an even more concentrated forum of A.H.F. In the reissue patent, column 2, lines 36 et al, it is indicated that the heparin is preferably added to the A.H.F.-rich concentrate in addition to citrate. A preferred method of conducting the aouble anticoagulant addition is to add the heparin to the cryoprecipitate in Lne form of a heparinized, citrated-saline solution. When the A.H.F.-rich cryoprecipitate is further fractionated to obtain a high purity, more concentrated form of A..F., heparin is preferably added twice, once to the initial cryoprecipitate and subsequently to the further fractionated A.H.F. concentrate. In each case, heparin is preferably added along with citrate as a second anticoagulant. It is especially important to note that, in the original Fekete patent and the reissue patent, the plasma is received frozen from a donor centre and then a cryoprecipitate step is performed before the heparin is added. Heparin is added only to the cryoprecipitate or to the concentrate of A.H.F. after cryoprecipitation occurs. Reference should also be:made to Col. 4 of the Fekete reissue patent, lines 46-49,wherein it is clear, from the temperatures at which the cryoprecipitate is resolubilized, the CIg or fibronectin is lost and therefore unavailable to aid in the recovery of Factor VIII. According to Fekete, the yield of Factor VIII is improved from 13.6 or 12.5% in the non-heparinized procedure to 17% in the heparinized procedure. Fekete indicates that this increase of approximately 4% represents a 25% increase over the non-heparinized procedure. However, as the Table found in column 5 of the patent, Example 1, would indicate, the total yield from the cryoprecipitate is low at 35%, representing only 350 units per litre of starting plasma. Therefore, the 17% recovery in the final product represents only 170 units per litre of starting plasma. These calculations are based on the international reference standard of one unit per ml of plasma. It will be clear from the above discussion that the cold precipitation of fibronectin and fibrinogen had been an established procedure for many years prior to the filing date of the original Fekete patent in 1972. It was generally known that addition of heparin or some other polysaccharide compound was necessary in order to effect precipitation of fibronectin in the cold. However, at no point has the literature suggested or contained directions for the application of a cold-insoluble globulin or fibronectin step toward the production of Factor VIII. In fact, a 1975 paper by Mosher, entitled "Cross Linking of Cold-Insoluble Globulin by Fibrin-Stabilizing Factor", published in J.B.C. 250: 6614, 1975, indicated that cold-insoluble globulin was distinguished from antihemophilic factor (Factor VIII) by amino acid analysis and by the position of elution from 4% agarose gels and by the electrophoretic migration in polyacrylamide gels. According to the present invention, a method of obtaining Factor VIII comprises the steps of (a) adding heparin to freshly obtained blood plasma collected into a calcium chelating anti-coagulant or collecting blood plasma by plasmapheresis using heparin and a calcium chelating anti-coagulant; (b) freezing the plasma; (c) resolubilising the plasma; (d) isolating a cryoprecipitate from the plasma; (e) resolubilising the cryoprecipitate; (f) adding a citrate saline heparin buffer to the resolubilised cryoprecipitate; ; (g) incubating the buffered, resolubilised cryoprecipitate under conditions, e.g. a temperature of 0 from about 0 to about 10 C for a time in excess of about one hour, such that Factor VIII present in the cryoprecipitate is insolubilised using heparin-precipitable coldinsoluble globulin and the resulting Factor VII-rich precipitate also includes cold-insoluble globulin; (h) separating the Factor VIII-rich precipitate; and (i) isolating the Factor VIII from the precipitate. The calcium chelating anti-coagulant can be selected from any of the well known anti-coagulants which function by lowering the physiological level of calcium in the blood or blood plasma. The preferred such anticoagulants are the citrate anti-coagulants, ethylenediaminetetraacetic acid (EDTA), and oxalates. Of these, the citrate anticoagulants are preferred. The preferred citrate anticoagulants include.acid-citrate-dextrose (ACD) and citrate-phosphate-dextrose (CPD). The essential steps of the method of this invention are the addition of the citrate saline heparin (CSH) buffer to the resolubilized cryoprecipitate and the incubation of the cryoprecipitate. The buffer is preferably added in amounts ranging from about 2 to about 10 ml per cryoprecipitate bag. More preferably, it is added in amounts from about 2 to about 4 ml per cryoprecipitate bag and,most preferably, an addition of 2.5 ml per cryoprecipitate bag is made. The buffer preferably has a composition of 0.2 M sodium citrate, 0.9% by weight of sodium chloride and 1 unit per ml of buffer of sodium heparin. The pH of the buffer is maint:a±ned at 7.2. The incubation, as stated before, is carried out at about 0 to about 1UOC for a time in excess of about one hour. Preferably, it is conducted at OOC for about two hours. Cold insoluble globulin (CIg) is not insolubilized after treatment of CPD plasma with heparin. The precipitate of the CIg is not formed until a specific set of conditions is met. Thus, while these conditions include introduction of heparin to fresh CPD plasma, this is not sufficient in itself to produce CIg. Indeed, visual observation indicates that this step alone does not produce the CIg since, when present, this material is seen as a white deposit at the bottom of a blood bag. These steps are the addition of the CSH buffer to the cryoprecipitate and the cold incubation step which permits formation of the precipitating globulin. If these combined steps are not employed, cold-insoluble globulin is not formed even in the presence of heparin. More specifically, the invention may be characterized as a method of obtaining Factor VIII which comprises a) adding heparin to freshly obtained blood plasma collected into a citrate-phosphate-dextrose anticoagulant or collecting blood plasma by plasmapheresis using heparin and sodium citrate anticoagulant; b) freezing the plasma to about -800C; c) resolubilizing the plasma at a temperature from about 0 to about lO0C for from about 30 to about 120 minutes, preferably at about 40C for about 75 minutes; d) centrifuging the resolubilized plasma to isolate a cryoprecipitate; e) resolubilizing the cryoprecipitate at a temperature of about 370C for about 2-5 minutes; f) adding from about 2 to about 10 ml citrate saline heparin buffer to each resolubilized cryoprecipitate bag; ; g) incubating the buffered, resolubilized cryoprecipitate at about OOC for about two hours, whereby Factor VIII present in the cryoprecipitate insolubilized using heparin-precipitable cold-insoluble globulin, the resulting Factor VIII-rich precipitate also including cold-insoluble globulin; h) separating the Factor VlII-rich precipitate; and i) isolating the Factor VIII therefrom. Factor VIII may be isolated from the Factor VIII-rich precipitate by washing the insoluble precipitate in the cold at a temperature of from about OOC to about lO0C, preferably at about 00with citrate saline heparin buffer. The precipitate is then drained and resolubilized with further citrate saline heparin buffer, preferably at about 370C for 2 to 5 min. The Factor VIII-rich solution can then be separated from the remaining debris, most easily by centrifugation. The Factor VIII-rich solution obtained will be of intermediate purity when the starting plasma is obtained from whole blood from which the red blood cells have been separated. In the case where the starting plasma is pheresis plasma, the Factor VIII will have an activity which qualifies it as high purity. Alternatively,or when required, the Factor VIII-rich precipitate can be subjected to conventional processes for obtaining high purity Factor VIII, examples of which are fractionation by precipitation, by glycine, ethanol, ethanol-glycine, polyethylene glycol, or glycine-polyethylene glycol precipitation and/or other known purification agents. The heparin is preferably added at a concentration of 1 unit heparin per ml of plasma, although a range of from about 1 to about 10 units heparin per ml of plasma is effective. Sodium heparin has proved effective in this method The method in precise terms involves freezing the fresh CPD plasma with the heparin added thereto at -800C and then resolubilizing at 40C for 75 minutes, after which it is centrifuged (spin 7000 x g, 7 min. at OOC). The resulting cryoprecipitate is allowed to resolubilize at 370C for 2-5 minutes, after which 2.5 ml of CSH (citrate saline heparin) buffer is added per cryoprecipitate bag. The resolubilized, pooled cryoprecipitate is then incubated at OOC for two hours in a refrigerated water bath. The Factor VIII present in the cryoprecipitate pool now insolubilizes along with the cold-insoluble globulin, and the total insoluble precipitate is then separated from the Factor VIII-poor supernatant by centrifugation (spin 7000 x g, 7 min. at OOC). After draining off the supernatant, the cold-insoluble precipitate is washed at OOC with 10 ml of cold CSH buffer, drained and allowed to resolubilize at 370C for five minutes with from 2-10 ml, preferably two ml, of CSH buffer per original cryoprecipitate bag. A further centrifugation (spin 3700 x g, 6 min. ) is conducted and the Factor VIII-rich solution is separated from the debris. The accompanying drawing is a chart illustrating the invention, the particular steps being illustrated for a pool of six units of plasma. The previous specifically described method is illustrated by this drawing. In the following Table 1, there is provided an analysis of the given illustrative embodiment of the invention. CPD plasma was separated from red blood cells (RBC) and made to one unit with sodium heparin, per ml of freshly-obtained human blood plasma. The plasma was frozen (-800C) and stored (-60 C) with cryoprecipitate prepared within S days. Approximately 9 mls volume was kept in each bag. Six bags or units of plasma were used to illustrate the method. The Table sets out out the total units of Factor VIII present in each of three Fractions obtained in sequence (Fraction 1 is the starting plasma, Fraction 2 the cryoprecipitate pool and Fraction 3 the cold-insoluble precipitate); the Factor VIII recovery level in comparison to the starting level; the protein recovery level; the specific activity of the Factor VIII units per milligram of protein; the purity of the Factor VIII; the volumes of each of the fractions; and the volume level. TABLL 1 Fraction 1 Fraction 2 Fraction 3 Total Factor VIII (Units) 1633 1325 1017 F. VIII Recovery (%) 100 81 62 Total Protein (mg) 131,520 4770 1220 Protein Recovery (t) 100 3.6 0.9 Specific Activity (U/mg) .0124 .278 .834 Purity wrt Plasma 1 x 22.4 x 67.25 x Volume Cml) 1527 53 11.3 Volume Recovery (t) 100 3.5 0.7 It will be seen that the cryprecipitate pool and the cold-insoluble globulin preiciptate fractions respectively provide 886 and 666 units per litre of Factor VIII or 81t and 62t recovery. This can be compared with the 17 recovery reported b Fekete et al in column 5, Example 1 of the US Reissue Patent discussed above; this recovery figure represents only 170 units per litre of starting plasma. Table 2 gives an analysis of the total contents of Fractions 1, 2 and 3. Factor VIII was purified from the cryoprecipitate by cold-incubation at 0 0C for 2 hours in the presence of CSH buffer. The 6 bags of CPD plasma to which heperin had been added were pooled after cryoprecipitate. The percentage component recovery figures were determined relative to the levels in the starting plasma. Protein was determined by Lowry assay with bovine serum albumin as standard. RID (Radial Immunodiffusion) plates for albumin or fibrinogen were used to determine the concentration of these components. Standard plasma containing known amounts of albumin and fibrinogen were provided by Behring Diagnostics. TABLE 2 Fraction 1 Fraction 2 Fraction 3 Total Protein (mg) 131,520 4770 1220 Protein Recovery (t) 100 3.6 0.9 Total Fibrinogen (mg) 4404 424 384 Fibrinogen Recovery (cho) 100 9.6 8.7 Total Albumin (mg) 65,906.4 1908 163 Albumin Recovery (cho) 100 2.9 .25 Antibody Titre 1:32 1:32 1:16 Volume (ml) 1527 53 11.3 Volume Recovery (t) 100 3.5 .74 Application of the cryoprecipitate-cold insoluble globulin procedure to citrate plasma obtained by plasmapheresis using the Haemonetics Model 50 machine with the plasma made to 1 unit of sodium heparin per ml of plasma also produces a Factor VIII concentrate of considerable potency. This technique results in the recovery of 81-83% of the initial plasma Factor VIII:C activity in the cryoprecipitate and an overall recovery in the final cold-insoluble globulin precipitate of 56-62% of the initial plasma Factor VIII activity. The specific activity of the final product is 0.96-0.99 units/mg of protein with a 99-160 fold increase in purity compared to plasma. As indicated in Tables 4 and 5, the data indicate that, when using plasmapheresis plasma, it is possible to increase the recovery to produce a concentrate with a specific activity which qualifies the compound as high purity (greater than 1 unit/mg). TABLE 3 Recovery of F.V,II:C/ml From Citrate and 1 Unit Heparin Per ml Pheresis Plasma by tne Cold-Insoluble Cryoprecipitate Technique sample , F.VIII: Volume Total 2 Recovery Unit/Liter C/ml Units Over Starting Plasma F.VIII:C Plasma Tubes: CPD Plasma 60%/ml - - - ¯ Citrate Plasma 60z/ml - Pheresis: : Citrate Plasma 60%/ml 2032 mls 1219U 10070 600U/L and Heparin (1 U/ml) Cryoprecipitate 1120%/nit 85 mls 1015U 83% 500U/L Pool Cold-Insoluble 2520%/ml 28.1 mls 755U 62 372U/L Cryoprec ipitate (Washed) Four volunteers (3 0's, 1A) were plasmapheresed on a model 50 Haemonetics pheresis machine with 1 part 4 g% sodium citrate per 14 parts blood. They were also collected into CPD or citrate tubes as usual. TALE 4 Specific Activity of citrate and heparin pheresis plasma fractions Fraction Total Total Specific Purity Over F.VIII:C Protein Activity Plasma (mg) Plasma 1219U 195,072 G.006U/mg (Citrate + 1 Unit Heparin/ml) Cryoprecipitate 1015U 5,032 0.201U/mg 33.5x Pool Cold-Insoluble 755.3U 786.8 0.96U/mg 160x Cryoprecipitate It is believed that the method of the invention will be of utility in blood donor centres, and possibly also in the larger scale recovery of Factor VIII.

Claims: CLAIMS 1. A method of obtaining Factor VIII, which comprises the steps of: Ca) adding heparin to freshly obtained blood plasma collected into a calcium chelating anti-coagulant or collecting blood plasma by plasmapheresis using heparin and a calcium chelating anti-coagulant; (b) freezing the plasma; (c) resolubilising the plasma; (d) isolating a cryoprecipitate from the plasma; (e) resolubilising the cryoprecipitate; (f) adding a citrate saline heparin buffer to the resnlubilised cryoprecipitate; (g) incubating the buffered, resolubilised cryoprecipitate under conditions such that Factor VIII present in the cryoprecipitate is insolubilised using heparin-precipitable cold-insoluble globulin and the resulting Factor VIII-rich precipitate also includes coldinsoluble globulin; ; (h) separating the Factor VIII-rich precipitate; and (i) isolating the Factor VIII from the precipitate. 2. A method according to claim 1 wherein the calcium chelating anti-coagulant is a citrate anti-coagulant, ethylendiaminetetraacetic acid or an oxalate. 3. A method according to claim 1 wherein the calcium chelating anti-coagulant is a citrate anticoagulant, preferably an acid-citrate-dextrose or a citratephosphate-dextrose. 4. Amethod according to any preceding claim wherein the blood plasma is collected by plasmapheresis using heparin and sodium citrate. 5. A method according to any preceding claim wherein the buffered, resolubilised cryoprecipitate is incubated at from 0 to 100C for at least one hour. 6. A method of obtaining Factor VIII which comprises the steps of: (a) adding heparin to freshly obtained blood plasma collected into a citrate-phosphate-dextrose anticoagulant or collecting blood plasma by plasmapheresis using heparin and sodium citrate anti-coagulant; 0 (b) freezing the plasma to about -80 C; (c) resolubilising the plasma at from 0 to 1OOC for from 30 to 120 minutes; (d) centrifuging the resolubilised plasma to isolate a cryoprecipitate; (e) resolubilising the cryoprecipitate at about 370C for from 2 to 5 minutes; (f) adding from 2 to 10 ml of citrate saline heparin buffer per bag of the resolubilised cryoprecipitate; ; (g) incubating the buffered, resolubilised cryoprecipitate at about 0 0C for about two hours whereby Factor VIII present in the cryoprecipitate is insolubilised using heparin-precipitable cold-insoluble globulin and the resulting Factor VII I-rich precipitate also includes coldinsoluble globulin; (h) separating the Factor VIII-rich precipitate; and (i) isolating the Factor VIII from the precipitate. 7. A method according to any preceding claim wherein,in step (c), the plasma is resolubilised at about 4 0C for about 75 minutes. 8. A method according to any preceding claim wherein,in step (i), the Factor VIII is isolated from the precipitate by washing the insoluble precipitate at from 0 to 100C, preferably about OOC, with citrate saline heparin buffer; draining the precipitate; and resolubilis 0 ing the precipitate, preferably at about 37 C, in the presence of further citrate saline heparin buffer. 9. A method according to any preceding claim wherein the isolated Factor VIII is subjected to further purification comprising, for example, fractionation by precipitation by glycine, ethanol, ethanol-glycine, polyethylene glycol or glycine-polyethylene glycol.

Inventors: PALMER, DOUGLAS STEPHEN, ROCK, GAIL ANN
Applicants: PALMER, DOUGLAS STEPHEN, ROCK, GAIL ANN, THE CANADIAN RED CROSS SOCIETY
Application year: 1981
Main classification: C07G7
IPC codes: A61K38, C07K14